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Effective with the new year, Institute for Collaborative Development (ICD) has changed its name to ThinkWell. Along with the name change, we have a new logo, new color scheme and a new website.

After nearly four years known as ICD, why the change?

“I founded ICD with a small team of emerging experts and a vision to bring transformative  solutions to development problems,” Yogesh Rajkotia, Founder & CEO explained. “As we’ve grown over the years, we felt it was important to communicate our identity such that it better captures our ethos, culture, and way of seeing the world. We stand for more than a generic development acronym — we represent a fresh, challenging, cutting-edge approach to development. I hope our new brand conveys this.”

What does ThinkWell mean? First and foremost, we bring a thoughtful approach that is both practical and grounded. We “think” beyond broad ideologies and generic models, and focus on context, what is doable, and what is politically acceptable. We are bold and creative — a “well” of ideas, options, and solutions.

We hope you enjoy the fresh new colors and unusual vertical orientation. The vertical design is a nod to the water well, and the blue is symbolic of that.

What to Expect

ThinkWell maintains the same energetic team and provides the same quality services as before. Our services are unchanged.

In addition to our new website www.thinkwell.global, each team member has a new email address ending in @thinkwell.global, which you will find on the Our Team page. Please take some time to enjoy the new website and check regularly for updated content. We would be delighted to hear any feedback!

 

Tunisia’s revolution is often cited as the first in the series of regional uprisings known as the “Arab Spring.” Dissatisfaction with public services, oppressed civic engagement and structural inequalities served as the catalyst for a wave of civil protests and violent clashes throughout Tunisia. And with little opportunity to voice their discontent, Tunisians took to the streets, media outlets and social networks openly calling for change. But the civil protests, rallies and media campaigns were not unique to Tunisia. Citizens across the Arab Region showed civil resistance in similar ways, demanding regime change, democracy and human rights. However, the current political landscape and level of civic participation is so disparate when one compares Tunisia to other Arab Spring countries, like Egypt and Yemen, that it warrants deeper exploration.

Why Tunisia’s Success?

The mere presence of civil uprising was not the sole driving force that brought Tunisia to its current state. After traveling to Tunisia to conduct key informant interviews about civic participation, I propose that it is citizen participation in governance that has sustained the momentum of the Arab Spring and fostered revolutionary change in Tunisia. And participatory governance in Tunisia was orchestrated by civil society organizations (CSOs) in very specific ways.

Firstly, Tunisia ousted a political regime through solidarity. Tunisia was the first country in the region to dissolve the ruling party, redistribute power and institute structural changes that opened the political space for civil society. Tunisian CSOs served as the linkage between diverse groups of citizens, unifying them around similar oppositional concerns of governance. The strong presence and collaborative nature of Tunisia’s CSOs, from the beginning of the Arab Spring, allowed them to elevate the demands of citizens in an unparalleled display of solidarity.

Secondly, under the new political regime, Tunisia made revolutionary changes that opened up political space for CSOs and citizens alike. The creation of a robust representative Tunisian parliament allowed for the loosening of the longstanding legal restrictions on civil society, allowing CSOs to actively participate in governance issues. In addition to a new legal framework, targeted investment, institutional reforms and capacity building of CSOs allowed for the use of diverse accountability mechanisms and new social channels for civic participation. One example of a CSO developing new engagement channels is Al Bawsala’s constitutional process watchdog project. During the drafting of the constitution from 2011-2014, Al Bawsala monitored the process and publicly reported on the activities of each of the more than 200 members of parliament (MPs). They established a website to publicize biographies, voting records and absenteeism records of each MP, and found that both citizens and the MPs were responsive to this type of open accountability platform.

This type of innovative and strategic use of civic participation and accountability mechanisms by CSOs in Tunisia has lead to an increase in resources and political space for civil societies to flourish. This created a positive feedback loop leading to an influx of international support that has allowed for continued growth and autonomy for CSOs working on governance issues.

Thirdly, Tunisia was primed for change. A relatively small revolutionary stimulus quickly ignited an entire nation in support of widespread regime change. Emboldened citizens were ready to take action, and CSOs worked quickly to adapt or create new channels for citizens to engage. The participation and civil society activism from youth energized and sustained the momentum for change. Young Tunisians successfully leveraged technology and media to increase access to information, creating a social movement around online platforms for public accountability.  Again I use Al Bawsala as an example of the role of technology and access to information in accountability with their launch of www.marsad.tn in July 2014. The site lists each municipality’s human resources, projects, budgets, demographics, access to electricity, education (number of schools, students per classroom), and more. It also rates the municipalities on their level of public transparency. The website is a critical resource for citizens and civil society to monitor local budgets, projects, and human resources. This sets the tone for the decentralization of public services and establishing of the citizen’s role in public service delivery.

Lessons for the Arab Region and Beyond

Despite a past of political hierarchy and oppression, Tunisian citizens demanded change, sought information, and strategically leveraged CSOs. CSOs like Al Bawsala and many others are making important contributions by using technology to create public accountability and provide citizens with access to information. CSOs were able to elevate civic participation, enabling them to sustain momentum from the Arab Spring and make remarkable progress towards democratic development.  The state’s role in opening space for CSOs to create new channels for participation and accountability ensures that centralized governmental power cannot revert back to the historic status quo. CSOs are the critical linkage between the state and groups of citizens, unifying and elevating the needs of constituents and working with the state to be responsive.

Tunisia is an important example for the rest of the region. The country made prompt legal reforms to support the functioning of CSOs.  With greater political space, CSOs served as the linchpin in the political and institutional transition of Tunisia. With legal, informational, and organizational structures in support, change can happen and it can sustain.

Yogesh Rajkotia, ThinkWell’s Founder and CEO, spoke at the 2014 Africa Forum on Universal Health Coverage (UHC) in December in Addis Ababa. The event was hosted by the Korean International Cooperation Agency.

Over 90 countries have endorsed the United Nations resolution on UHC. Dr. Rajkotia’s presentation discussed health financing trends that have emerged from countries’ drive toward UHC. Over 55 countries have implemented or plan to implement health insurance programs. Over 50 countries have implemented or plan to implement results-based financing. Dr. Rajkotia explained the steep increases in such programs, “Countries are seeking more effective ways to use available funding. Increasingly, health financing mechanisms are being used to drive the efficiency of programs, thus financing is serving to reshape the health sector.” His advice to countries? “Think big and plan ahead.”

Dr. Rajkotia went on to describe the importance of developing specific solutions that work for each country’s context. Traditional, standard models no longer apply. Increasingly, experienced experts are emerging from low and middle income countries, thus making south-to-south information exchange and collaboration an effective way to access advice on adapting customized solutions.

Dr. Rajkotia acknowledged that “Power and politics remain critical factors in developing local solutions. Politics drives progress.” Health financing mechanisms, like providing health cards to each citizen, have increased awareness among citizens, and brought on calls for increased information and involvement. Another way in which health financing has influenced the dynamic is by the defining and strengthening of the purchaser’s role in health services. Purchasing agents — which in a sound design are independent entities, separate from a Ministry of Health — are gaining more purchasing power and more autonomy from Ministries of Health, and are also invested in the benefits offered and the quality of the health services delivered. Dr. Rajkotia points to positive examples of health financing reforms driving improvements to health access and quality, such as Ghana’s successful national health insurance scheme, and the opportunity created for Morocco by its Arab Spring neighbors.

Dr. Rajkotia’s presentation is available on www.thinkwell.global/publications/.

 

 

This past December, I spoke at the Korea Foundation for International Healthcare’s (KOFIH’s) 2014 International Forum on Universal Health Coverage (UHC) in Addis Ababa. I also had the opportunity to deliver a keynote speech at KOFIH’s 7 year anniversary celebration in Seoul in 2013. I spend a lot of time at various international conferences and knowledge sharing events, but I was particularly inspired to witness the interactions between Korean health systems practitioners and their counterparts across Asia and Africa. The Korean approach is different: in the way they bring people together to exchange information, in the way they approach development. This synergized well with my observations about what is needed to help countries achieve UHC.

The Evolving State of Health Systems in LMICs

In my speech in Addis Ababa, I spoke of the evolution of health financing in low- and middle-income countries (LMICs). I discussed how international partners, mostly from Europe and North America, drew from their own experiences to support this evolution in its early stages. They introduced concepts found in Bismarkian, Beveridge and market-driven models of health systems. But the growing global chorus to achieve UHC has created the impetus for countries to develop unique health systems models tailored to the LMIC context. And these models look very different than the traditional models from upper income countries – just look at the mixed models in Rwanda, Ghana, and Philippines.

So who is best suited to support LMICs as they continue their journey towards UHC? I believe that it’s LMICs themselves. Rooted in practicality, their thinking goes beyond the standard models and transcends conventional wisdom. And, with over 55 countries having introduced or planning to introduce insurance, and 50 having introduced or planning to introduce results-based financing, the pool of health systems practioners from LMICs is growing every day.

KOFIH seems to have embraced this reality into their approach, while at the same time offering lessons from their own bumpy journey towards UHC.

The Difference from Korea

The South Koreans’ approach to foreign assistance is undoubtedly influenced by their own remarkable transformation – from a country devastated by the Korean War in the 1950s to becoming the 12th largest economy in the world today. Since the end of the war until the late 1990s, Korea received $12 billion in foreign assistance, while today Korea is providing $1.7 billion in foreign assistance annually as an OECD Development Assistance Committee member.

At the same time, they project an unbiased and agnostic approach to assistance. In examining KOFIH’s work, it is clear that they do not push particular models, methodologies, or agendas. Their role is largely informative and facilitative – bringing peer countries together to share knowledge, exchange experiences, and generate solutions. They pair Korea’s innovative health agencies, such as Health Insurance Review and Assessment Service (HIRA) and National Health Insurance Service (NHIS) with budding counterpart agencies in LMICs. They understand that development is a process, and naturally, every process is unique. Most importantly, they do not expect any individual country’s development to look like South Korea’s.

The Koreans are still finding their feet in how to best engage in foreign assistance. Their strategies will surely evolve as they continue to learn about the dynamics in LMICs, narrow their focus, and harmonize their various foreign assistance agencies. But they are on to something. And it is a refreshing message for low- and middle-income countries, one I believe should be emulated by other providers of foreign assistance.

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